Vaginal birth after cesarean: a 5-year experience in a family practice residency program.

BACKGROUND The national health objective for the year 2000 is to have an overall Cesarean section rate of 15 percent, a primary Cesarean section rate of 12 percent, and a vaginal birth after Cesarean (VBAC) rate of 35 percent. The current national statistics for the most recent year available, 1991, are 23.5 percent, 17 percent, and 24.2 percent, respectively. This study evaluates a VBAC program at a community-hospital-based family practice residency program. METHODS This study was a retrospective chart review of 996 family practice service deliveries from 1988 to 1992. RESULTS Of the 98 patients who had a previous Cesarean section, 87 patients (89 percent) were eligible for a trial of labor. Fifty-six patients (64 percent) accepted a trial of labor and 31 patients (36 percent) refused. The overall Cesarean section rate was 15 percent, the primary Cesarean section rate was 11 percent, the VBAC rate was 44 percent, and the successful VBAC rate was 77 percent. CONCLUSION We report a successful VBAC program at a community-hospital-based family practice residency program.